While you advocate for your patients, ADHA advocates for you. Position statements help succinctly state and amplify the views of dental hygienists while educating decision-makers. Expand each link to read the full statement.
The American Dental Hygienists’ Association (ADHA®), recognizes that workforce challenges across oral health care are real and persistent. New research confirms what dental hygienists have reported for years: the profession is not suffering from a shortage of qualified people. It is suffering from a systemic failure to keep them.
The ADA Health Policy Institute (HPI), in its April 2026 analysis of the dental hygiene workforce shortage, confirmed that only 60% of dentists report having adequate hygiene staffing and that 91% of those actively recruiting rate it as very or extremely challenging. The same report acknowledges that this dynamic has persisted unchanged for three years despite record enrollment in dental hygiene programs. The ADA’s own data show that new graduates are replacing those exiting the field, not expanding it, meaning the pipeline alone cannot solve the problem.
The 2022 Dental Workforce Shortages: Data to Navigate Today’s Labor Market report, produced jointly by ADA HPI, ADHA and other oral health care organizations, identified the chronic, non-pandemic drivers of hygienist departure: negative workplace culture, insufficient compensation, lack of growth opportunity, inadequate benefits, feeling overworked, and communication failures in the practice environment. These are retention failures, not pipeline failures.
The recently published GoTu 2026 State of Work Report, the largest ongoing study of the U.S. dental workforce, developed in partnership with ADHA and reflecting responses from nearly 8,000 dental professionals across all 50 states, makes the urgency undeniable. Three years of data now confirm the following:
- 59% of dental professionals received no raise in the past two years. 74.7% receive no bonus. 44.7% have no benefits at all. Better compensation has ranked as the top desired improvement for three consecutive years, by a 20-point margin over the next item.
- Burnout affects 54.1% of all dental professionals and 60.6% of dental hygienists specifically. The leading causes are workload (65.7%) and toxic office culture (62.4%). These are structural, organizational conditions that cannot be resolved at the individual level.
- 64% of dental professionals report that their longest tenure at any single practice is five years or less. Office-switching is accelerating, not stabilizing.
- 62% of dental hygienists report that greater clinical autonomy would increase their likelihood of staying in the profession. Clinical autonomy is a retention tool that is structurally underutilized.
- 8% of respondents plan to remain in dentistry for at least the next decade. The commitment to the profession is intact. What is eroding is the willingness to remain in specific workplaces that do not offer fair pay, reasonable culture, and professional respect.
Taken together, these three data sources — two produced in direct partnership with ADHA — build an unambiguous case: the dental hygiene workforce shortage is a retention crisis, not a supply crisis.
ADHA has reviewed the workforce solutions proposed in recent ADA HPI analysis and by other dental organizations. These proposals include allowing foreign-trained dentists to practice as dental hygienists, expanding the scope of dental assistants to perform hygiene-adjacent procedures, and accelerating alternative licensure pathways. Several states have moved to implement such models.
ADHA does not support these approaches as solutions to the dental hygiene workforce shortage. Substituting alternative personnel for licensed dental hygienists does not address why hygienists leave. It bypasses the evidence in favor of short-term labor replacement, and in doing so, it risks patient safety, undermines professional standards, and further demoralizes a workforce that is already signaling distress. Replacing professionals who leave because of poor conditions with less-trained workers under the same conditions is not a solution. It is a continuation of the identified problem.
ADHA notes with concern that these proposals have been advanced even as the ADA’s own HPI research, co-produced with ADHA, documents precisely why hygienists are leaving and what would bring them back. Workforce policy that ignores jointly produced evidence is not a data-driven approach. ADHA calls on the ADA, dental employers, and policymakers to follow the data.
ADHA maintains that the most effective, ethical, and durable solution to the dental hygiene workforce shortage is to address the conditions that cause hygienists to leave and to build a profession that trained, licensed dental hygienists actively choose to remain in. The ADHA supports the following evidence-based priorities:
- Fair, responsive, and transparent compensation that reflects the education, licensure, and clinical responsibility dental hygienists carry. Wages must be assessed against current market data and adjusted accordingly.
- Competitive benefits, including health insurance, paid leave, and continuing education funding, that are standard in comparable health care roles and currently absent for nearly half the dental hygiene workforce.
- Positive, accountable workplace culture. Poor communication, bullying, and toxic leadership are among the top drivers of departure. Culture is not a soft issue. It is a retention variable with measurable consequences.
- Professional autonomy and full utilization of scope of practice. Nearly two-thirds of hygienists report that expanded clinical autonomy would increase their likelihood of staying in the profession. Policies that restrict hygienists from practicing at the full extent of their training are a structural barrier to both retention and patient access.
- Licensure portability through the Dentist and Dental Hygienist (DDH) Compact. Among hygienists familiar with the Compact, 89.6% support it, and more than half report high likelihood of practicing in another state if it were in effect. The Compact is a direct, evidence-supported mechanism for expanding workforce access in underserved markets using professionals who are already trained, already licensed, and already committed to the profession.
- Targeted pipeline growth through the Hygienist Inspired Chairside Recruitment Program, now active in nine pilot states, developed in partnership with the Delta Dental Foundation. Recruitment must be paired with retention reform to be effective.
- Professional development, mentorship, and career pathways that give dental hygienists meaningful reasons to grow within the profession rather than exit it.
ADHA continues to engage directly with dental organizations and other stakeholders in ongoing collaborative discussions about workforce solutions. We actively seek out and build partnerships grounded in shared evidence and shared commitment to patient safety and professional integrity.
The solutions to the dental hygiene workforce shortage are not unknown. They have been documented, validated, and published repeatedly in research this profession helped produce. What remains is implementation at the practice level, where hygienists decide whether to stay or go. The dental hygiene workforce is committed to dentistry. What they are asking for, consistently and across years of data, are workplaces that make staying sustainable. Meeting that ask is the right thing to do and the most effective workforce strategy available.
© American Dental Hygienists’ Association, 2026
This statement supersedes the December 2, 2024 ADHA Position Statement on Dental Hygiene Workforce Shortage.
Key sources: ADA HPI, “We Have a Major Dental Hygienist Shortage” (April 2026); ADA HPI, “State of the U.S. Dental Economy Q1 2026” (April 2026); ADA HPI/ADHA, “Dental Workforce Shortages: Data to Navigate Today’s Labor Market” (2022); GoTu/ADHA, “State of Work Report, 3rd Edition” (April 2026); ADHA, “Workforce Growth Initiatives” (April 2026).
The American Dental Hygienists’ Association (ADHA®) is deeply concerned by the Department of Education’s decision to exclude dental hygiene from its proposed definition of professional degree programs.
On November 6, 2025, the U.S. Department of Education’s Reimagining and Improving Student Education (RISE) Committee reached a consensus on federal student loan-related changes in response to the One Big Beautiful Bill Act (OBBBA). Beginning in July 2026, the OBBBA caps annual loans for new borrowers at $20,500 for graduate students ($100,000 aggregate limit) and $50,000 for professional students ($200,000 aggregate limit).
Under the Department’s proposed narrow definition, professional degrees include pharmacy, dentistry, veterinary medicine, chiropractic, law, medicine, optometry, osteopathic medicine, podiatry, and theology—but exclude programs such as a master’s in dental hygiene.
The policy would also eliminate Grad PLUS loans forcing students to seek private loans with higher interest rates.
While the Department frames these changes as a mechanism to hold institutions accountable and place downward pressure on tuition costs, ADHA voices concern that students in programs requiring additional funding may face greater financial strain. Limiting access to higher federal loan amounts could impact students pursuing advanced degrees and create barriers to entry into the healthcare field, particularly as our nation faces critical workforce shortages.
The proposed definition requires that a program: demonstrate completion of education needed to begin practice, provide training beyond the bachelor’s level, generally be at the doctoral level with at least six years of postsecondary coursework, and generally require professional licensure.
ADHA urges the Department of Education to engage with stakeholders in the healthcare sector, revise its proposed definition of professional degrees, and support advanced education that promotes entry into the healthcare field.
ADHA will continue to advocate for dental hygiene students and encourages the dental hygiene community to participate in the public comment period when it opens.
© American Dental Hygienists’ Association, 2025
The American Dental Hygienists’ Association (ADHA®) and the International Federation of Dental Hygienists (IFDH) strongly advocate for the delivery of dental hygiene care exclusively by qualified professionals who have completed proper accredited educational programs and obtained licensure in compliance with the regulatory standards of the nation in which they are practicing.
As essential oral health professionals, dental hygienists play a vital role in disease prevention, health promotion, clinical assessments and therapeutic care. At the entry level, licensed dental hygienists take at a minimum 84-120 credit hours to complete a rigorous, focused curriculum ADEA – Dental Hygiene Programs. Those with advanced degrees take even more credit hours to enhance their professional knowledge and competency. To safeguard public health, uphold quality standards, and maintain professional accountability, it is imperative that only those who have met established educational, clinical, and licensing requirements provide dental hygiene services.
We advocate for policies that:
- Recognize dental hygienists as primary oral healthcare providers with the authority to practice autonomously within their full scope of education and licensure.
- Ensure that all providers of dental hygiene care meet rigorous educational standards established by accredited institutions to maintain excellence in person-centered care.
- Support licensure systems that uphold competency-based qualifications to protect patient safety and advance best practices in oral healthcare.
- Oppose the provision of dental hygiene services by unqualified or inadequately trained individuals, as this compromises patient outcomes, professional integrity, and public trust.
- Oppose the provision of dental hygiene services by unqualified or inadequately trained individuals as this could be detrimental to patient health.
The ADHA and IFDH remain steadfast in their commitment to advancing the profession, protecting public health, and ensuring that all individuals receive safe, high-quality care from properly trained, educated, and licensed dental hygienists. Such standards are vital to promote the health of the public in the United States and around the world.
© American Dental Hygienists’ Association and International Federation of Dental Hygienists, 2025
The American Dental Hygienists’ Association (ADHA®) calls on all dental hygienists to uphold the integrity of the profession and prioritize public safety by adhering to the ADHA Code of Ethics.
The ADHA Code of Ethics is a framework centered on professional responsibility, development, and the well-being of those we serve, ensuring that care is delivered with the highest standards of safety, integrity, and accountability. It serves as the ethical cornerstone of dental hygiene practice, embodying our profession’s core values of individual autonomy, confidentiality, societal trust, non-maleficence, beneficence, justice and fairness, and veracity. This framework is essential for navigating complex ethical dilemmas and fostering ethical decision-making among members of the profession.
By establishing clear standards of professional responsibility, the Code strengthens public trust and ensures accountability to individuals, colleagues, the profession, and society. It empowers dental hygienists to advocate for vulnerable populations, resist workplace exploitation, and promote equitable access to care. A unified commitment to ethical practice and professional accountability is essential for preventing harm, reducing healthcare disparities, and protecting the well-being of the communities we serve.
Adherence to the ADHA’s ethical standards ultimately safeguards both individuals and practitioners, while upholding the integrity of the dental hygiene profession. We urge all dental hygienists to incorporate the Code of Ethics into daily practice, because it is a testament to our collective commitment to public safety, professional excellence, and the advancement of oral health for all.
To view the ADHA Code of Ethics visit: https://www.adha.org/ADHA-Code-of-Ethics
© American Dental Hygienists’ Association, 2025
The American Dental Hygienists’ Association (ADHA®) opposes the passage of H4842, a measure permitting alternative pathways for individuals seeking licensure as dental hygienists in Massachusetts. While this legislation aims to address workforce shortages, it compromises the professional standards and integrity of dental hygiene practice.
The ADHA opposes policies that allow individuals to obtain dental hygiene licensure through alternative pathways. Permitting individuals in complementary roles to practice dental hygiene without completing the same extensive education and clinical training is harmful to patients and undermines the profession’s integrity.
H4842 includes provisions for nontraditional pathways, such as allowing internationally trained dentists to pass a standardized board examination to obtain licensure without formal dental hygiene training. This bypasses the rigorous and comprehensive education provided by U.S. dental hygiene programs accredited by the Commission on Dental Accreditation (CODA). Dental hygiene education is specialized and distinct from other curricula, such as dentistry. These pathways fail to meet the critical standards necessary to ensure patient safety and uphold the integrity of dental hygiene practice.
The ADHA firmly believes that any individual seeking to practice dental hygiene in the U.S. must complete a CODA-accredited dental hygiene education program and meet the clinical training, examination, and practice requirements necessary to earn a dental hygiene license, without exception.
While the ADHA acknowledges and commends the collaborative efforts of the Massachusetts Dental Hygienists’ Association to address workforce challenges and increase licensure standards, we maintain that formal dental hygiene education remains the only acceptable foundation for practicing dental hygiene.
At a time when workforce shortages challenge access to dental care, solutions must prioritize public safety, maintain professional standards, and focus on improving patient outcomes. Expanding eligibility for licensure without maintaining these standards is not the solution. The ADHA encourages dental hygienists and supporters to express their concerns regarding H4842.
© American Dental Hygienists’ Association, 2025
The American Dental Hygienists’ Association (ADHA®) opposes the adoption of the Dental Access Model Act, crafted by the American Dental Association (ADA) and supported by the American Legislative Exchange Council (ALEC).
This proposed model advocates for dental assistants to perform scaling — a critical, preventive and therapeutic procedure that falls within the scope of dental hygiene practice that requires specialized education and clinical training.
The Dental Access Model Act is based on a recently initiated pilot program supported by the Missouri Dental Association and legislation enacted in Wisconsin. The Act and its adoption are controversial because there are no available data or reported outcomes of the pilot program demonstrating safety, appropriateness, or efficacy of allowing dental assistants to perform scaling procedures. Prematurely expanding this model without supporting evidence endangers patient safety, compromises quality of care, and undermines the established standards of dental hygiene practice. Further, the minimal training of an oral preventive assistant is not comparable to the extensive didactic and clinical education required for dental hygienists to competently perform these services.
While the new model Act may increase productivity, it primarily increases profits for private fee-for-service dental practices, rather than making dental care more accessible to all those in need, including the underserved. This model demonstrates dentists’ prioritization of self-interest rather than the interest of the public.
Dental hygienists provide high quality preventive and therapeutic oral health care, which involves far more procedures than scaling. Their expertise encompasses thorough general and oral health assessments, including oral pathology screenings, periodontal staging and grading, performing breathing and airway assessment, identifying caries, providing preventive care, performing complete scaling therapy for patients with gingivitis, carrying out scaling and debridement for those with periodontitis, facilitating behavior, assisting with tobacco cessation and nutritional counseling and offering evidence-based individualized recommendations for self-care. When dentists authorize inadequately trained personnel to perform scaling, the public should be advised that they are at risk of receiving substandard care.
In addition, the ADA incorrectly assumes that there are many healthy patients that need only limited care. In fact, most Americans suffer from either gingivitis or periodontitis, making comprehensive dental hygiene care essential. Scaling alone, without other preventive and therapeutic services, poses risks including long-term implications for oral and overall health. Even seemingly healthy individuals require the comprehensive preventive care provided in a visit with a dental hygienist, which goes far beyond what a scaling assistant can offer.
It is contradictory that while the ADA claims their model will solve dental workforce shortages, they are creating another group that also requires supervision. Further, the ADA opposed ALEC’s endorsement of dental therapists – proven licensed providers who have safely delivered quality care to underserved populations for over 15 years in the United States. Dental therapy will increase access to care and is not tied to a private fee-for-service model.
Another concern with adopting this model is ADA’s failure to engage ADHA in discussion during its development and continuing to disregard existing workforce shortage data that suggests straightforward solutions. Additionally, ALEC neglected to perform due diligence by failing to obtain testimony from ADHA and other key stakeholders before endorsing this Act. The adoption of this Act requires further study while simultaneously acknowledging dental therapy legislation that ALEC supported in the past.
For these reasons, the ADHA firmly opposes the adoption of the Dental Access Model Act and urges stakeholders to pursue evidence-based solutions that prioritize patient safety and improved access to oral healthcare.
The ADHA encourages individuals and state groups to express their opposition to the Dental Access Model Act by contacting their state legislators, members of the ALEC Board of Directors, or ALEC’s CEO Lisa Nelson at [email protected].
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) maintains its strong support of community water fluoridation as a safe, effective and equitable public health measure.
The consumption of fluoridated water has been proven to prevent dental caries and improve the oral health of individuals of all ages. Decades of rigorous scientific research and endorsements from respected organizations, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), validate its effectiveness in significantly reducing dental caries in children and adults.
The ADHA urges dental hygienists to advocate for the adoption and continuation of water fluoridation in their communities, to educate the public on its safety and effectiveness, and to collaborate with other health professionals on the promotion of community water fluoridation as a measure to combat oral health disparities.
More than 70 years of research have consistently demonstrated that fluoridating public water supplies is a safe and cost-effective way to reduce tooth decay and alleviate the broader burden of dental disease. The ADHA supports this evidence-based practice as part of our mission to improve oral health outcomes and ensure a healthier future for everyone.
To view ADHA’s policies and other resources on fluoride and community water fluoridation visit https://www.adha.org/fluoride.
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) opposes policies for alternative dental hygiene licensure pathways for non-hygienists.
The ADHA opposes any policies supporting dental students, residents, and foreign-trained dentists with an alternative pathway to obtain dental hygiene licensure and practice dental hygiene in the United States and increasing the faculty-to-student ratios in dental hygiene education programs.
Allowing those in roles that are complementary to dental hygiene to practice the profession without the same extensive dental hygiene education and practical training is harmful to patients and damaging to the standards of the dental hygiene profession.
U.S. dental hygiene education at programs accredited by the Commission on Dental Accreditation (CODA) is deeply comprehensive and includes significant faculty supervision for upholding the highest standards of dental hygiene practice. The curriculum for dentists dedicated to dental hygiene is not comparable.
The ADHA firmly believes that any individual seeking to practice dental hygiene in the U.S. must complete a CODA-accredited dental hygiene education program, and meet the clinical training, examination and practice requirements necessary to earn a dental hygiene license, without exception.
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) recognizes the dental hygiene workforce shortage and supports appropriate strategies to retain and build the workforce.
As the largest organization advocating for the dental hygiene profession, the ADHA recognizes the workforce shortage of dental hygienists, dentists and other allied oral healthcare workers. An increase in the recruitment and retention of trained, educated, licensed professionals to restore and grow the oral healthcare workforce is needed.
In order to fully address the dental hygiene workforce shortage, it is critical to rely on data that have been collected from dental hygienists regarding their current and future needs. The 2022 research report, “Dental Workforce Shortages: Data to Navigate Today’s Labor Market”, produced through a collaboration between the ADHA, the American Dental Association (ADA) Health Policy Institute and other oral healthcare organizations, identified several chronic factors, beyond pandemic-related and retirement reasons, driving dental hygienists to leave the profession. The report revealed staff retention challenges citing inadequate benefits, non-responsive compensation, poor communication, lack of professional fulfillment and negative workplace culture as key contributing factors to workforce attrition.
While the ADHA does not support the resolutions adopted in October 2024 by the American Dental Association (ADA) concerning dental workforce shortages, we look forward to addressing the identified workforce-related issues in partnership with the ADA and other related dental professional organizations.
The ADHA supports addressing the issues that underlie workforce departures and enhancing recruitment into the profession as more appropriate strategies to retain and build the dental hygiene workforce. The ADHA is leading efforts to resolve dental hygiene workforce shortages through constructive measures. These include supporting and advising on the creation of additional entry-level dental hygiene programs and on the increase in capacity of current entry-level dental hygiene programs, where appropriate. The ADHA offers webinars and workshops on addressing workplace culture, leadership, professional empowerment and autonomy. Additionally, the ADHA is developing a new chairside recruitment program aimed at expanding the dental hygiene workforce. We encourage other dental professional organizations to address their specific workforce issues.
The ADHA recognizes the complexity of the situation and supports collaborating with other dental-related groups on fostering professional autonomy and empowering dental hygienists to work to their full scope of practice, which will lead to better health outcomes for the public and improve workplace culture.
© American Dental Hygienists’ Association, 2024